Fu Yao-Yao, Li Chen-Long, Zhang Jun-Li, Zhang Tian-Yu
ENT Institute, Eye & ENT Hospital, Fudan University, Shanghai, China; Department of Facial Plastic and Reconstructive Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China.
Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China.
Int J Pediatr Otorhinolaryngol. 2019 Jan;116:1-6. doi: 10.1016/j.ijporl.2018.09.035. Epub 2018 Oct 2.
The Brent or Nagata techniques of microtia reconstruction and their modifications involve complicated frameworks; therefore, complications are inevitable. The authors aimed to provide comprehensive knowledge regarding the occurrence, development, prognosis, risk factors, and treatment of complications.
This study was a retrospective review of patients who underwent autologous cartilage microtia reconstruction at a single auricular plastic and reconstructive center between March 2005 and June 2016. Custom database software was used to process data from patients with microtia. Details of postoperative complications were collected during follow-up for analysis.
A total of 470 procedures (stage I) were performed on 429 patients. The mean (±SD) age at surgery was 12.27 ± 5.01 years (range, 6-32 years). The mean time to follow-up was 3.67 ± 2.45 years (range, 1-11 years). The complication rate was 2.98% (4/134) with the Brent technique and 12.2% (38/311) with the Nagata technique. A multivariate logistic regression analysis of complications of microtia reconstruction revealed that age, sex, and laterality were not associated with postoperative complications (p > 0.05). Surgical technique affected the incidence of complications. The Nagata technique resulted in a higher risk for complications (OR 6.14 [95% CI 1.63-23.19]; p < 0.01).
The development of complications was a dynamic process. There was a learning curve associated with autologous cartilage microtia reconstruction. Orthopedists or otologists aspiring to master microtia reconstruction should have a fundamental understanding of the procedure and be aware of possible complications.
布伦特（Brent）或永田（Nagata）耳廓再造技术及其改良方法涉及复杂的支架结构；因此，并发症不可避免。作者旨在提供有关并发症的发生、发展、预后、危险因素及治疗的全面知识。
本研究是对2005年3月至2016年6月期间在单个耳廓整形与再造中心接受自体软骨耳廓再造的患者进行的回顾性研究。使用定制数据库软件处理来自小耳畸形患者的数据。在随访期间收集术后并发症的详细信息进行分析。
共对429例患者进行了470次手术（I期）。手术时的平均（±标准差）年龄为12.27±5.01岁（范围6 - 32岁）。平均随访时间为3.67±2.45年（范围1 - 11年）。布伦特技术的并发症发生率为2.98%（4/134），永田技术为12.2%（38/311）。对耳廓再造并发症的多因素逻辑回归分析显示，年龄、性别和患侧与术后并发症无关（p>0.05）。手术技术影响并发症的发生率。永田技术导致并发症的风险更高（比值比6.14 [95%可信区间1.63 - 23.19]；p<0.01）。
并发症的发生是一个动态过程。自体软骨耳廓再造存在学习曲线。有志于掌握耳廓再造技术的骨科医生或耳鼻喉科医生应基本了解该手术并知晓可能的并发症。
